Dr. Toby Cosgrove on healthcare, the Cleveland Clinic under the PPACA

After visiting the Cleveland Clinic in 2009, President Barack Obama recognized the system as a model others should aim to emulate, according to The Washington Post. Five years after the Patient Protection and Affordable Care Act was signed into law, Toby Cosgrove, MD, president and CEO of the Cleveland Clinic, tells CNBC his perspective on the PPACA's effects on healthcare in general and on the clinic.

Dr. Cosgrove said he sees some positive changes, noting healthcare inflation has fallen while quality metrics have gone up, in addition to 13 million new people becoming enrolled in health insurance.

Dr. Cosgrove would not assign a letter grade to the PPACA, instead calling it a "long-term project," according to the report.

"One of the things we have to do is keep costs down, and we have to sustain it. As more and more people come in and we have an older population, it's going to be more difficult to do," Dr. Cosgrove told CNBC.

Since Dr. Cosgrove, a former cardiovascular surgeon, took the helm of the Cleveland Clinic in 2004, the organization has become one of the United States' largest healthcare institutions. More than 5.5 million patients visited the Cleveland Clinic and its member hospitals last year alone, according to CNBC.

However, the clinic has lately experienced some financial difficulties, resulting in the reduction of its more than $6 billion annual budget, with some observers linking the cut to effects of the PPACA.

Dr. Cosgrove explained that two and a half years ago, Cleveland Clinic "looked to the future" and knew they had to cut the budget. He said the clinic planned to reduce the budget by 20 percent, or $1.5 billion out of $6.5 billion, and in the last 18 months they have extracted about $500 million in costs.

Care Pass, Cleveland Clinic's system of streamlining procedures, has allowed the organization to reduce spending significantly.

"With Care Pass, you take the very best of how you do a procedure, take care of somebody and standardize it. That takes out the variation. As you take the variation out, you improve the quality and reduce the cost," said Dr. Cosgrove.

Dr. Cosgrove also discussed the Cleveland Clinic's progress in improving patient access to care. For example, the clinic's renowned same-day appointment philosophy has enabled more than 1 million same-day appointments a year at Cleveland Clinic facilities. Additionally, the clinic has developed a mobile stroke unit, one of two in the country.

Mobile stroke units — or ambulances equipped with a CAT scan — can be dispatched to patients' homes if they present stroke symptoms. They can potentially be treated right in their driveways, eliminating travel time to hospitals and thereby saving brain tissue.

Dr. Cosgrove said the Cleveland Clinic will be further developing its virtual patient-physician visits that build on the universality of mobile apps.  

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